Sdsd| GENERAL MICROBIOLOGY

CHAPTER 15: SPECIFIC HOST DEFENSE MECHANISMS:

AN INTRODUCTION TO IMMUNOLOGY

- immunity that results from the

IMMUNOLOGY active production or receipt of
- the scientific study of the immune antibodies during one’s lifetime
system and immune responses - Active acquired immunity
THE PRIMARY FUNCTIONS OF IMMUNE ● Antibodies are produced
SYSTEM within the person
● differentiate between "self" and ● Usually provides
"nonself" long-lasting protection
● Destroy that which is "nonself" - Passive acquired immunity
Cells involved in immune responses ● Antibodies are received
originate in bone marrow that were produced by
THREE LINES OF LYMPHOCYTES ARE another person(s) or by an
DERIVED FROM LYMPHOID STEM CELLS OF animal
BONE MARROW ● Usually provides only
● B lymphocytes (B cells) temporary protection
● T lymphocytes (T cells)
➢ Helper T cells
ACTIVE ACQUIRED IMMUNITY
➢ Cytotoxic T cells
TWO TYPES OF ACTIVE ACQUIRED
● Natural killer cells (NK cells)
IMMUNITY
TWO MAJOR ARMS OF THE IMMUNE
1. Natural active acquired immunity
SYSTEM
- occurs naturally
● Humoral immunity
2. Artificial active acquired immunity
- where special glycoproteins
- Artificially induced
called antibodies are
Artificial active acquired immunity
produced by B cells to
- results when a person receives a
destroy specific microbes
vaccine
● Cell-mediated immunity
- VACCINE
- involves a variety of cell
● defined as material that can
types, with antibodies
artificially induce immunity
playing only a minor role, if
to an infectious disease,
any
usually following injection
or ingestion of the vaccine
THE TWO MAJOR ARMS OF THE IMMUNE ● Most vaccines are made
SYSTEM from living or dead
pathogens or the toxins
that they produce

HOW VACCINES WORK

VACCINES
- stimulate the recipient’s immune
system to produce protective
antibodies
● antibodies that will protect
the person from disease
IMMUNITY TYPES OF AVAILABLE VACCINES
ACQUIRED IMMUNITY ● Attenuated vaccines
● Inactivated vaccines
 ● Subunit vaccines blood that
● Conjugate vaccines participate in
● Toxoid vaccines immune reactions

PASSIVE AQUIRED IMMUNITY

Antibodies produced in one person are
transferred to another person to protect
the latter from infection—provides
temporary protection.
TWO TYPES OF PASSIVE ACQUIRED
IMMUNITY
● Natural passive acquired immunity
- Small antibodies, IgG,
present in mother’s blood
cross the placenta to reach
the fetus
● Artificial passive acquired
immunity
- Antibodies from an immune
person are transferred to a
susceptible person
➔ hepatitis B
immunoglobulin
(cont.)
● Antibodies
HUMORAL IMMUNITY - The amount and type of
● Antigens antibodies produced by a
- Foreign organic substances given antigenic stimulation
that are large enough to depend on the nature of
stimulate the production of the antigen, the site of
antibodies antigenic stimulus, the
- ANTIGENIC amount of antigen, and the
(IMMUNOGENIC) number of times the person
● Substances capable is exposed to the antigen
of stimulating - MAJORITY OF ANTIGENS
antibodies ● T-dependent
- A bacterial cell has many antigens
molecules (antigenic - T cells are
determinants) on its required in
surface that are capable of their
stimulating the production processing
of antibodies T-dependent antigens
● Antibodies - Requires T cells
- Proteins produced by T-dependent antigens
lymphocytes in response to - Requires only B cells
the presence of an antigen
- Belong to a class of
- proteins called
IMMUNOGLOBULINS
● globular PROCESSING OF T-INDEPENDENT
glycoproteins in the ANTIGENS
 Antibody structure and function
- ANTIBODIES
● are a class of glycoproteins
called immunoglobulins
● FIVE TYPES
➢ IgA
➢ IgD
➢ IgE
➢ IgG
➢ IgM
- ALL antibodies
● are immunoglobulins, but
NOT ALL immunoglobulins
are antibodies

STRUCTURES OF THE DIFFERENT CLASSES

OF ANTIBODIES
HUMORAL IMMUNITY (cont.)
● Antibodies (cont.)
- The processing of either
T-dependent or
T-independent antigens
results in B cells developing
into plasma cells
● capable of
secreting
antibodies
- PRIMARY RESPONSE
● The initial immune
MONOCLONAL ANTIBODIES
response to an
- HYBRIDOMAS
antigen
● long-lived,
● it takes 10 to 14
antibody-producing cells
days for antibodies ● produced by combining a
to be produced single plasma cell and a
- SECONDARY RESPONSE rapidly dividing tumor cell
● The increased ● are capable of producing
production of large amounts of specific
antibodies antibodies called
following the MONOCLONAL ANTIBODIES
second exposure to - are used in immunodiagnostic
a particular antigen procedures
Where do immune responses occur? ➔ immunologic procedures
- Immune responses to antigens in used in laboratories to
the blood are usually initiated in diagnose diseases
the spleen - are being evaluated for possible use
- responses to microbes and other in fighting diseases, killing tumor
antigens in tissues are generated in cells, boosting the immune system,
lymph nodes located near the and preventing organ rejection
infected area.
 ANTIGEN-ANTIBODY COMPLEXES HYPERSENSITIVITY
● When an antibody combines with - overly sensitive immune system
an antigen, an antigen–antibody DIFFERENT TYPES OF HYPERSENSITIVITY
complex (or immune complex) is REACTIONS
formed - Immediate-type
● capable of activating the ● occurs from within a few
complement cascade, which results minutes to 24 hours after
in some of the following effects: contact with a particular
- Activation of leukocytes antigen
- Lysis of bacterial cells ● three types:
- Increased phagocytosis as a ➢ Types I HSR
result of opsonization ➢ Types II HSR
➢ Types III
CELL-MEDIATED IMMUNITY hypersensitivity
reactions
● Antibodies are unable to enter cells
- Delayed-type
● A complex system of interactions
● TYPE IV HYPERSENSITIVITY
among many types of cells and
REACTIONS
cellular secretions (cytokines)
● usually takes more than 24
● An arm of the immune system
hours to manifest
capable of controlling chronic
themselves
infections by intracellular
pathogens
➔ certain bacteria TYPE I HYPERSENSITIVITY REACTIONS
➔ protozoa - ANAPHYLACTIC REACTIONS
➔ fungi - they include:
➔ viruses ● Classic allergic responses
● Examples of cells that participate in ➢ hay fever
CMI: symptoms
➢ macrophages ➢ asthma
➢ TH cells ➢ hives
➢ TC cells ➢ gastrointestinal
➢ NK cells symptoms that
➢ granulocytes result from food
NATURAL KILLER (NK) CELLS allergies
- a subpopulation of lymphocytes ● Allergic responses to insect
called large granular lymphocytes stings and drugs
- They resemble lymphocytes, but ● Anaphylactic shock
lack typical T or B cell surface THE ALLERGIC RESPONSE
markers. - Type I immediate hypersensitivity
- Do not proliferate in response to ● probably the most common
antigen and appear not to be type of hypersensitivity
involved in antigen-specific - ATOPIC PERSONS
recognition. ● People prone to allergies
- NK cells kill target cells, including ● produce IgE antibodies
foreign cells, host cells infected with when exposed to allergens
viruses or bacteria, and tumor cells. (antigens that cause allergic
reactions).
HYPERSENSITIVITY AND HYPERSENSITIVITY - The allergic reaction results from
REACTIONS the presence of IgE antibodies
bound to basophils in the blood or
 to mast cells in connective
tissues—IgE antibodies that were
produced in response to the
person’s first exposure to the
allergen.
FACTORS IN THE DEVELOPMENT OF TYPE I
HYPERSENSITIVITY
EVENTS THAT OCCUR IN TYPE I
HYPERSENSITIVITY
TYPE I HYPERSENSITIVITY REACTIONS
(cont.)
SYSTEMIC ANAPHYLAXIS
- Results from the release of
chemical mediators from basophils
in the bloodstream
- Occurs throughout the body—much
more serious than localized
anaphylaxis
- Common allergens involved are
drugs and insect venom
LATEX ALLERGY
- Latex can trigger any of three types
of reactions:
● irritant contact dermatitis
● allergic contact dermatitis
● immediate type
hypersensitivity
ALLERGY SKIN TESTING AND ALLERGY
SHOTS
- Anaphylactic reactions can be
prevented by avoiding
- known allergens, which is often
difficult to do.
- SKIN TEST (SCRATCH TEST)
● are used to identify
offending allergens in
patients
● positive test is indicated if
cutaneous anaphylaxis
occurs at the site of the
scratch.
- Immunotherapy
➔ allergy shots—IM
doses of the
allergen
● may be used to treat the
patient
- IgG blocking antibodies
● produced in response to
allergy shots
TYPE II HYPERSENSITIVITY REACTIONS
- are cytotoxic reactions, meaning
that body cells are destroyed during
these reactions
SEQUENCE OF EVENTS IN A TYPE II
HYPERSENSITIVITY REACTION:
1. A particular drug binds to the
surface of a cell.
2. Antidrug antibodies then bind to
the drug.
3. Complement activation on the cell
surface is initiated.
4. The complement cascade leads to
lysis of the cell
TYPE III HYPERSENSITIVITY REACTIONS
- immune complex reactions—such
as those that occur in serum
sickness and certain autoimmune
diseases
 ➢ systemic lupus
erythematosus
➢ rheumatoid arthritis
- Involve IgG or IgM antibodies,
complement, and neutrophils
- Some complications of untreated or
inadequately treated strep throat
and other Streptococcus pyogenes
infections are the result of type III
hypersensitivity reactions
➢ rheumatic fever
➢ glomerulonephritis
TYPE IV HYPERSENSITIVITY REACTIONS
- are delayed-type hypersensitivity
(DTH) or cell-mediated immune
reactions, and are part of
cell-mediated immunity
● Reactions are usually
observed 24 to 48 hours or
longer after exposure or
contact
- delayed-type hypersensitivity
(DTH)
● prime mode of defense
against intracellular
bacteria and fungi
● involves a variety of cell
types, including
➔ macrophages
➔ cytotoxic T cells
➔ NK cells
- antibodies
do not play
a major
role
Positive TB skin test
- Classic example of DTH
AUTOIMMUNE DISEASE
- result when a person’s immune
- system no longer recognizes certain
body tissues as “self” and attempts
to destroy those tissues as if they
were “nonself” or foreign
- May occur with certain tissues that
are not exposed to the immune
system during fetal development
and, thus, are not recognized as
“self.”
- There are more than 80 recognized
autoimmune diseases.
- Can be classified as:
● organ-specific
● non–organ-specific
- Examples:
➔ Hashimoto thyroiditis
➔ Graves disease
➔ systemic lupus
erythematosus
IMMUNOSUPPRESSION
- IMMUNOSUPPRESSED
● Persons whose immune
systems are not functioning
properly
- ACQUIRED IMMUNODEFICIENCIES
● may be caused by drugs
(e.g., cancer therapeutic
agents), irradiation, or
certain infectious diseases
(e.g., HIV infection)
- INHERITED IMMUNODEFICIENCY
DISEASE
● can be the result of
deficiencies in antibody
production, complement
activity, phagocytic
function, or NK cell function
➔ DiGeorge syndrome
➔ Wiskott–Aldrich
syndrome
- People born lacking the ability to
produce antibodies (i.e., gamma
globulins) have
agammaglobulinemia; people not
producing a sufficient amount of
antibodies are said to have
hypogammaglobulinemia
IMMUNODIAGNOSTIC PROCEDURES
- help diagnose infectious diseases by
detecting either antigens or
antibodies in clinical specimens
- test results are usually available on
the same day
THREE POSSIBLE REASONS FOR THE
PRESENCE OF ANTIBODIES TO A
PARTICULAR PATHOGEN
● Present infection
 ● Past infection
● Vaccination
A variety of different laboratory tests have
been designed to observe the presence of
an antibody–antigen reaction.
- Examples of these tests include
➢ agglutination
➢ precipitin tests
➢ immunofluorescence
➢ enzyme linked
immunosorbent assays
(ELISAs or EIAs)

PRINCIPLES OF ANTIGEN AND ANTIBODY

DETECTION PROCEDURES

BLOOD TYPING

AGGLUTINATION PROCEDURE

IMMUNODIAGNOSTIC PROCEDURES
(cont.)
AGGLUTINATION PROCEDURE FOR ABO SKIN TESTING
BLOOD TYPING - Performed in vivo
- Antigens are injected within or
beneath the skin.
- Examples:
● TB skin test
● allergy testing
Procedures Used in the Diagnosis of
Immunodeficiency Disorders
- For assessment of patient’s immune
status and evaluation of
immunodeficiency disorders
- Include B-cell deficiency states,
cell-mediated immunodeficiencies,
complement deficiencies, CD4 T cell
counts, etc.